CMS Price Transparency Data

X-ray, ankle

Facility: Fairview Hospital

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $229
Cash Discount Price: $385
vs. Medicare Baseline: 2.58x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at Fairview Hospital is $229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $385. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.58x the Medicare baseline. Located in 29 Lewis Avenue, Great Barrington, MA.

Cash / Self-Pay

$385

Average discount available for prompt cash payment at this facility.

Insurance Median

$229

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $385 (433%)

Insurance Median: $229 (258%)

Cash: $385 (433% of Medicare)

Ins. Median: $229 (258% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 258% of the Medicare baseline (a markup of 158%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$25 - $306	28%
Workers Comp	$27 - $258	30%
Health New England	$29 - $283	33%
Medicaid / KanCare	$29 - $143	33%
Point32Health	$32 - $385	36%
Bmchnp	$34 - $149	38%
Other Government	$37 - $158	42%
Medicare (plans)	$38 - $156	43%
Hospice	$39 - $158	44%
UnitedHealthcare	$39 - $348	44%
Fallon	$40 - $178	45%
Blue Cross Blue Shield	$44 - $344	49%
Commcare Alliance	$46 - $155	52%
Comm Fallon Qhp	$56 - $250	63%
Unicare	$69 - $263	78%
Comm Hne Hmo	$71 - $267	80%
Comm Hne Ppo	$75 - $284	84%
Allways Nhp	$228 - $262	256%
Capital District Physicians' Health Plan	$317 - $365	357%
Cigna	$317 - $377	357%
Mvp	$317 - $365	357%
Oxford	$317 - $365	357%
First Health	$327 - $385	368%
Connecticare	$334 - $385	376%
Consolidated Health Plans	$334 - $385	376%
Other Commercial	$334 - $385	376%
Phcs	$334 - $385	376%
Self Pay	$334 - $385	376%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $385.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fairview Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73610.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.